JP5750890B2 - Fluid ejecting apparatus and medical device - Google Patents

Description

  The present invention relates to a fluid ejecting apparatus and a medical device.

  In recent years, a surgical technique has been developed in which a liquid such as water or physiological saline is pressurized and sprayed onto the affected tissue site during surgery to excise the affected tissue site with the pressure of the liquid. In the fluid ejecting apparatus used for such an operation, the liquid is ejected from the ejection port provided at the tip of the nozzle, and the operator ejects the liquid toward the affected site tissue site through the ejection port of the nozzle. It is possible to excise the affected tissue site.

  Further, in the water jet surgical apparatus that excises the affected tissue site by injecting pressurized water, the pressurized gas injected together with the pressurized water removes the pressurized water that hits the affected tissue site, and the pressurized water is applied to the affected tissue site in the firing state. There has been proposed a water jet surgical apparatus that prevents accumulation and, as a result, can effectively apply pressurized water to an affected tissue site (see, for example, Patent Document 1).

JP-A-6-192

  However, in the technique of Patent Document 1, since the pressurized gas is injected in a state surrounding the periphery of the pressurized water, when the pressure of the pressurized water is low, the injection direction of the pressurized water is easily affected by the pressurized gas, and the excision is performed. There was a risk of misalignment at the location. In addition, when pressurized water is jetted in a pulsed manner, it is particularly susceptible to great influences, and there is a risk that displacement will occur at the excision site.

  SUMMARY An advantage of some aspects of the invention is to solve at least a part of the problems described above, and the invention can be implemented as the following forms or application examples.

  Application Example 1 A fluid ejecting apparatus that excises the excision site by ejecting the fluid from the fluid ejection opening toward the excision site, the fluid chamber having a variable volume, and the fluid chamber communicating with the fluid chamber A pulsation generator comprising: an inlet channel and an outlet channel, and a volume changing unit that changes the volume of the fluid chamber in response to supply of a drive signal; and an end portion that communicates with the fluid chamber of the outlet channel A fluid ejection pipe that ejects fluid from the fluid ejection opening that communicates with an end that is different from the fluid ejection pipe, and a gas ejection flow path that is disposed on the outer circumference of the fluid ejection pipe, And a gas injection pipe for injecting gas from a gas injection opening communicating with the end of the gas injection flow path, and an inner diameter of the fluid injection pipe in the fluid injection opening is the fluid injection opening The inner diameter of the fluid ejection pipe at a position closer to the fluid chamber than the portion It also large fluid jet apparatus characterized Ri.

  Thereby, without affecting the ejection of the fluid from the fluid ejection opening, gas is blown out from the gas ejection opening at a high pressure, and the drained liquid collected at the bottom of the excision site or the excised living tissue , Expressed as a resected tissue piece) and removed, and the affected visual field can be secured.

  In addition, the gas injected from the gas injection opening pressurizes the surface of the affected tissue site surrounding the excision site or pushes the excision site outward, and increases the shear stress at the excision site by opening the excision site. In addition, by making the fluid ejected from the fluid ejection opening reliably reach the bottom, it is possible to synergistically improve the excision ability and ensure excision.

  Application Example 2 In the fluid ejecting apparatus, a gas ejection adjusting unit that adjusts an ejection direction of the gas ejected from the gas ejection opening according to a distance between the fluid ejection opening and the cut portion. The fluid ejecting apparatus further comprising:

  According to this, since the spread of the compressed gas can be changed, the compressed gas can be matched with the region where the compressed gas hits the excision site. Furthermore, when the distance between the gas injection opening and the excision site becomes long and the wind pressure of the compressed gas is greatly attenuated, the amount of wind pressure reaching the excision site can be increased by increasing the injection amount of the compressed gas. The decrease can be suppressed.

  Application Example 3 In the fluid ejecting apparatus, the suction channel is disposed on the outer periphery of the gas ejection tube, and a suction channel is formed between the outer periphery of the gas ejection tube, and the end of the suction channel is formed. A fluid ejecting apparatus further comprising a suction pipe having a suction opening communicating with the suction pipe.

  As a result, it is possible to prevent the drainage and the excised tissue pieces from being collected or scattered in the affected part, and the gas injection volume per unit time of the gas injected from the gas injection opening is sucked by the suction opening. By making it larger than the suction volume per unit time of gas, it is possible to prevent the suction opening from adhering to the affected tissue site.

  Application Example 4 A medical device including the fluid ejecting apparatus.

  Thereby, since the affected part visual field is ensured, it is possible to provide a medical device having high safety and high excision ability.

Schematic which shows the fluid injection apparatus which concerns on 1st Embodiment. Sectional drawing which shows the injection | spray site | part and affected part tissue site | part of the fluid injection apparatus which concern on 1st Embodiment. Sectional drawing explaining the excision process of the affected part tissue site | part by the fluid injection apparatus which concerns on 1st Embodiment. The table | surface and graph which show the relationship between the wind speed and stress by the fluid injection apparatus which concern on 1st Embodiment. The table | surface which shows the relationship between the wind speed and stress by the fluid injection apparatus which concerns on 1st Embodiment. Sectional drawing explaining the area | region where the compressed gas by the fluid injection apparatus which concerns on 1st Embodiment hits a cutting location. Schematic which shows the fluid injection apparatus which concerns on 2nd Embodiment. Sectional drawing which shows the fluid injection apparatus which concerns on 2nd Embodiment.

  Hereinafter, the present embodiment will be described with reference to the drawings. Note that the drawings referred to in the following description are schematic views in which the vertical and horizontal scales of members or portions are different from actual ones for convenience of illustration.

(First embodiment)
FIG. 1 is a schematic view showing a fluid ejecting apparatus according to the present embodiment. As shown in FIG. 1, the fluid ejection device 2 according to the present embodiment includes a fluid container 10 in which a fluid such as physiological saline or a chemical solution is accommodated, a fluid supply unit 12 that sucks up the fluid from the fluid container 10, and a fluid supply A pulsation generator 14 that converts the fluid supplied from the means 12 into a pulsating flow (hereinafter, sometimes referred to as a pulse flow), a fluid ejection pipe 16 that communicates with the pulsation generator 14, and a pulsation generator 14 project The gas jet pipe 18, the compressed air supply pump 20, and the drive circuit unit 22 that controls the operation of the fluid jet device 2 are configured.

  The pulsation generator 14, the fluid supply means 12, and the fluid container 10 are connected by a first connection tube 24A and a second connection tube 24B. Further, the gas injection pipe 18 and the compressed air supply pump 20 are connected by a gas transport tube 26.

  The pulsation generating unit 14 can be applied as long as it is a piezo method using a piezoelectric element, a bubble jet (registered trademark) method, or the like that can convert a fluid into a pulsating flow and inject it in pulses. However, the pulsation generator 14 described below will be described by exemplifying a piezo method.

  The pulsation generator 14 includes a fluid chamber 30 whose volume can be changed, an inlet channel 30A and an outlet channel 30B communicating with the fluid chamber 30, and a volume change that changes the volume of the fluid chamber 30 in response to the supply of a drive signal. The piezoelectric element 42 and the diaphragm 44 as a part are provided.

  The fluid ejection pipe 16 has a fluid ejection channel 32 that communicates with a fluid chamber 30 formed inside the pulsation generator 14, and a fluid ejection opening with a reduced channel (not shown) at the tip. 28 is opened. The fluid ejection pipe 16 includes a fluid ejection opening portion 28 that communicates with an end portion that is different from the end portion that communicates with the fluid chamber 30 of the outlet channel. The fluid ejection pipe 16 is inserted in the gas ejection pipe 18. The fluid ejection pipe 16 and the gas ejection pipe 18 are arranged so as to be concentric.

  The gas ejection pipe 18 is disposed on the outer periphery of the fluid ejection pipe 16 so as to have a double pipe structure. A gap formed between the inner circumferential surface of the gas ejection pipe 18 and the outer circumferential surface of the fluid ejection pipe 16 is a gas ejection flow path 34, and gas is formed at the end of the gas ejection flow path 34 on the fluid ejection opening 28 side. An injection opening 36 is provided.

  The gas ejected from the gas ejection opening 36 is ejected along the outer wall of the fluid ejection opening 28. The gas injected from the gas injection opening 36 is formed to be a conical surface having the gas injection opening 36 as a vertex. The gas ejection opening 36 is formed so that the fluid ejected from the fluid ejection opening 28 and the cone-shaped gas ejected from the gas ejection opening 36 do not collide with each other. Thereby, since the fluid ejected from the fluid ejection opening 28 is not easily affected by the gas ejected from the gas ejection opening 36, the fluid ejected from the fluid ejection opening 28 is removed at the excision point P (see FIG. 2). There is little possibility of shifting from the position, and the excision ability can be maintained. It is desirable that the fluid ejection pipe 16 has a rigidity that does not deform or vibrate during fluid ejection, and the gas ejection pipe 18 has a rigidity that does not deform or vibrate during gas ejection.

  The operation of ejecting fluid or the operation of ejecting gas by the fluid ejecting apparatus 2 is controlled by the drive circuit unit 22. The drive circuit unit 22 of the present embodiment is provided with a fluid ejection control unit 38 that controls the operation of ejecting fluid and a compressed air supply control unit 40 that controls the operation of ejecting gas. The unit 38 is connected to the fluid supply means 12 and the pulsation generator 14, and the compressed air supply control unit 40 is connected to the compressed air supply pump 20. The fluid ejection control unit 38 controls the fluid supply unit 12 to change the supply amount of the fluid supplied to the pulsation generation unit 14 and controls the pulsation generation unit 14 so that the pulsation generation unit 14 ejects the fluid. Is changing. The fluid ejection control unit 38 transmits a drive signal for driving the piezoelectric element 42 so as to reduce the volume of the fluid chamber 30, and drives the piezoelectric element 42 so as to increase the volume of the fluid chamber 30 after supply. The drive signal to be transmitted is transmitted to the piezoelectric element 42. The fluid ejection control unit 38 controls the start and stop of driving of the fluid supply unit 12. The fluid ejection control unit 38 controls the pressure of the fluid that the fluid supply unit 12 supplies to the pulsation generator 14. The fluid ejection control unit 38 controls ejection of fluid by the pulsation generation unit 14. Specifically, the fluid ejection control unit 38 controls the voltage applied to the piezoelectric element 42 of the pulsation generating unit 14.

  The compressed air supply control unit 40 controls the compressed air supply pump 20 to reduce the supply amount of the compressed gas C or stop the supply.

  Next, the flow of fluid in the fluid ejecting apparatus 2 configured as described above will be briefly described. The fluid stored in the fluid container 10 is sucked by the fluid supply means 12 and supplied to the pulsation generator 14 through the second connection tube 24B at a constant pressure. The pulsation generator 14 drives the piezoelectric element 42 to generate a pulsating flow in the fluid chamber 30, and ejects fluid from the fluid ejection opening 28 through the fluid ejection channel 32 at high speed.

  When the pulsation generator 14 stops driving, that is, when the volume of the fluid chamber 30 is not changed, the fluid supplied from the fluid supply means 12 at a constant pressure passes through the fluid chamber 30 and is ejected from the fluid. Jetted as a continuous flow from the opening 28.

  Here, the pulsating flow means a fluid flow in which the fluid flow direction is constant and the fluid flow rate or flow velocity is periodically or irregularly changed. Although the pulsating flow includes an intermittent flow in which the fluid flows and stops repeatedly, the flow rate or flow velocity of the fluid only needs to fluctuate periodically or irregularly. Therefore, the pulsating flow is not necessarily an intermittent flow.

  Similarly, ejecting fluid in pulses means ejecting fluid in which the flow rate or flow velocity of the fluid to be ejected varies periodically or irregularly. An example of pulsed injection is intermittent injection in which fluid injection and non-injection are repeated. However, since the flow rate or flow velocity of the fluid to be injected only needs to fluctuate periodically or irregularly, the intermittent injection is not necessarily performed. There is no need.

  FIG. 2 is a cross-sectional view showing an ejection site and an affected tissue site of the fluid ejection device 2 according to the present embodiment. The injection part of the fluid injection device 2 is constituted by a double pipe, and the outer pipe is a gas jet pipe 18 and the inner pipe is a fluid jet pipe 16. A fluid ejection opening 28 is provided at the tip of the fluid ejection pipe 16. The fluid ejecting apparatus 2 performs excision of the excision site P by ejecting fluid from the fluid ejection opening 28 toward the excision site P. The fluid ejection opening 28 has, for example, a shape that widens toward the tip of the fluid ejection pipe 16. As a result, the compressed gas C injected from the gas injection opening 36 flows along the outer wall of the fluid injection opening 28, and thus affects the injection of the pulsed fluid injected from the fluid injection opening 28. In addition, the drainage fluid and the excised tissue pieces collected at the excision site P can be removed.

  FIG. 3 is a cross-sectional view illustrating the excision process of the affected tissue site by the fluid ejection device 2 according to the present embodiment. FIG. 4 is a table and graph showing the relationship between wind speed and stress by the fluid ejection device 2 according to the present embodiment. FIG. 5 is a table showing the relationship between wind speed and stress by the fluid ejection device 2 according to the present embodiment. As already described, the compressed gas C injected from the gas injection opening 36 that flows along the outer wall of the fluid injection opening 28 affects the injection of the pulse flow that is injected from the fluid injection opening 28. Therefore, the pulse flow reliably reaches the excision site P of the affected tissue site without being bent in flight. In addition, the drained fluid and the excised tissue pieces scattered around the excision site P can be removed.

  Furthermore, the compressed gas C that flows in a conical side surface (C shape) along the outer wall of the fluid ejection opening 28 pressurizes the affected tissue site surface and pushes the excision site P outward. By pressurizing the surface of the affected tissue site, the affected affected tissue site having flexibility can be substantially hardened, so that the energy of the pulse flow can be reduced from being absorbed and attenuated by the elasticity of the affected tissue site. Further, the stress PW2 that pushes outward from the center of the excision site P acts to increase the shear stress for excising and crushing the affected tissue site as shown in FIGS. 3 (A) and 3 (B). Can do. By both the above actions, the excision ability can be synergistically improved.

Here, the velocity of the compressed gas C injected from the gas injection pipe 18 is expressed as V (m / s), the specific gravity of the fluid is expressed as γ (kgf / m ³ ), and the acceleration of gravity is expressed as g (m / s ² ). The drag (= stress) D (kgf / m ² ) that the object receives from the fluid is expressed by the following equation.

D = Cd * [gamma] * V ^ 2 / 2g = Cd * 1.2 * V ^ 2 / 19.6≈Cd * (V / 4.04) ^ 2 (1)
Each coefficient has the following value. Specific weight of fluid: γ = 1.2 kgf / m ³ (gas: at 20 ° C., 60% RH, 1 atm), acceleration of gravity: g = 9.8 m / s ² , drag coefficient Cd = 1.0 (temporary value) When the relationship between the wind speed and the stress is derived using Equation (1), the results are as shown in FIGS.

  Here, when the stress shown in FIG. 4 (A) is completely applied to the affected tissue site (thickness 5 mm) having a characteristic of an elastic modulus of about 5 kPa, the deformation amount due to the stress of the affected tissue site is as shown in FIG. Thus, in order to apply a deformation amount (= push-open force) of 0.1 mm or more, a gas having a wind speed of 15 m / s may be injected.

When the inner diameter of the gas injection pipe 18 is 2 mm and the outer diameter of the fluid injection pipe 16 arranged inside thereof is 1.5 mm, the gas injection opening area is 1.37E-06 m ² , If gas is conveyed at 20 ml per second, a gas with a wind speed of about 15 m / s can be injected.

Here, the area | region where the compressed gas C hits the cutting location P is demonstrated.
FIG. 6 is a cross-sectional view illustrating a region where the compressed gas C hits the excision site P by the fluid ejection device 2 according to the present embodiment. The fluid ejection device 2 may include a gas ejection adjustment unit 46 in the fluid ejection opening 28. The gas injection adjusting unit 46 is configured to change the compressed gas C injected from the gas injection opening 36 according to the spread angle of the conical side surface of the outer wall of the fluid injection opening 28 according to the distance between the fluid injection opening 28 and the excision point P. Adjust the injection direction. In accordance with the distance (D) between the fluid ejection opening 28 and the excision site P, the interval between the positions where the compressed gas C hits the excision site P becomes a predetermined value (L). The opening angle (θ) is adjusted.

  Here, an ultrasonic sensor or an infrared sensor may be used to measure the distance (D) between the fluid ejection opening 28 and the excision site P. In the case where the distance between the fluid ejection opening 28 and the excision point P is a relatively close distance D1, as shown in FIG. 6A, in order to obtain the interval L1 of the position where the compressed gas C hits the excision point P, The opening angle θ1 of the conical side surface of the outer wall of the fluid ejection opening 28 is set.

  On the other hand, when the distance (D) between the fluid ejection opening 28 and the excision point P becomes a distance D2 farther than the distance D1, it corresponds to the excision point P of the compressed gas C as shown in FIG. In order to make the position interval L2 equal to the interval L1, the opening angle θ2 of the conical side surface of the outer wall of the fluid ejection opening 28 is changed so as to satisfy the relationship θ2 <θ1.

  In addition, as a mechanism for changing the opening angle (θ) of the conical side surface of the outer wall of the fluid ejection opening 28, a spring material is used in advance, and the conical side surface of the outer wall of the fluid ejection opening 28 has a predetermined opening angle (θ). The supply angle of the compressed gas C is adjusted, and the opening angle (θ) of the conical side surface of the outer wall of the fluid ejection opening 28 is adjusted. That is, the larger the supply amount of the compressed gas C, the smaller the opening angle (θ) of the conical side surface of the outer wall of the fluid ejection opening 28 is. Therefore, the conical side surface of the outer wall of the fluid ejection opening 28 is increased by increasing the supply amount of the compressed gas C as the distance (D) between the fluid ejection opening 28 and the excision P becomes longer (distance D2). The opening angle (θ) is small (angle θ2).

  As a result, since the spread of the compressed gas C becomes small, the interval L2 at the position where the compressed gas C hits the excision site P can be matched with the interval L1. Further, since the distance (D) between the fluid ejection opening 28 and the excision point P is increased, the supply amount of the compressed gas C is increased even if the wind pressure attenuation of the compressed gas C is increased. It is possible to suppress a decrease in wind pressure reaching the excision site P.

  According to the present embodiment, the liquid discharged from the gas ejection opening 36 at a high pressure without affecting the fluid ejection from the fluid ejection opening 28, The excised tissue piece can be pulled away and removed to ensure the visual field of the affected area.

  In addition, the affected tissue site surface surrounding the excision site P is pressurized, or the excision site P is pushed outward, and the excision site P is opened to increase the shear stress of the excision site P and securely to the bottom. By allowing the fluid ejected from the fluid ejection opening 28 to reach, the ablation capability can be synergistically improved and the ablation can be reliably performed.

(Second Embodiment)
Next, a second embodiment will be described. In the description of this embodiment, the same components as those in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.
FIG. 7 is a schematic view showing a fluid ejecting apparatus according to the present embodiment. As shown in FIG. 7, the fluid ejecting apparatus 4 according to the present embodiment includes a suction pipe 48 projecting from the pulsation generating unit 14, a suction pump 50 as suction means, and aspirated drainage and excised tissue pieces. And a collection container 52 for housing the container. The suction pipe 48, the suction pump 50, and the collection container 52 are connected by a third connection tube 54.

  The suction pipe 48 is disposed on the outer periphery of the gas ejection pipe 18 and is disposed so as to have a triple pipe structure including the fluid ejection pipe 16. A gap formed between the inner peripheral surface of the suction pipe 48 and the outer peripheral surface of the gas ejection pipe 18 is a suction flow path 56, and the suction opening 58 is provided at the end of the suction flow path 56 on the fluid ejection opening 28 side. Is arranged. The gas injection pipe 18 is inserted in the suction pipe 48. The gas injection pipe 18 and the suction pipe 48 are arranged so as to be concentric.

  The operation in which the fluid ejecting apparatus 4 sucks the fluid is controlled by the drive circuit unit 22. As shown in FIG. 7, the drive circuit unit 22 of the present embodiment is provided with a suction control unit 60 that controls the operation of sucking fluid, and the suction control unit 60 is connected to the suction pump 50. The suction control unit 60 controls the start and stop of the driving of the suction pump 50.

  Next, suction will be described. The fluid ejected from the fluid ejection opening 28 stays as drainage at the excision site P. In addition, a resected tissue piece is present in the affected area. The drainage and the excised tissue pieces are sucked from the suction opening 58 by the suction pump 50 and are stored in the recovery container 52 through the suction flow path 56 and the third connection tube 54. The suction pump 50 may be driven in conjunction with the drive of the pulsation generator 14, or may be driven intermittently periodically or when necessary.

  FIG. 8 is a cross-sectional view showing the fluid ejection device 4 according to the present embodiment. The fluid ejecting apparatus 4 is configured such that the ejecting portion is constituted by a triple tube, the outer tube is a suction tube 48, the middle tube is a gas ejecting tube 18, and the inner tube is a fluid ejecting tube 16. In addition, since the excised tissue piece can be collected by the suction tube 48, it is possible to suppress scattering to the outside.

  Further, the ejection volume per unit time from the gas ejection pipe 18 may be set larger than the suction volume per unit time from the suction pipe 48. By doing in this way, it can avoid that the excision location P is strongly attracted | sucked by the suction opening part 58, and the excision location P is damaged.

  Further, even when the gas is not sent from the gas injection tube 18 during the suction period, the suction opening 58 can be prevented from being sucked by the suction by connecting the suction opening 58 to the atmosphere. .

  By projecting the fluid ejection pipe 16 forward from the gas ejection pipe 18 disposed on the outer periphery thereof, the compressed gas C can be guided along the fluid ejection pipe 16 to the affected area, and the excision ability can be improved.

  According to the present embodiment, it is possible to prevent the drainage and the excised tissue piece from splashing outward, and the gas injection volume per unit time of the gas injected from the gas injection opening 36 is sucked by the suction opening 58. By making the gas volume larger than the suction volume per unit time, it is possible to prevent the suction opening 58 from sticking to the affected tissue site.

  DESCRIPTION OF SYMBOLS 2,4 ... Fluid injection apparatus 10 ... Fluid container 12 ... Fluid supply means 14 ... Pulsation generating part 16 ... Fluid injection pipe 18 ... Gas injection pipe 20 ... Pressure air supply pump 22 ... Drive circuit unit 24A ... 1st connection tube 24B ... 1st 2 connection tube 26 ... gas transport tube 28 ... fluid ejection opening 30 ... fluid chamber 30A ... inlet channel 30B ... outlet channel 32 ... fluid ejection channel 34 ... gas ejection channel 36 ... gas ejection opening 38 ... fluid ejection Control unit 40 ... Pressure air supply control unit 42 ... Piezoelectric element (volume changing unit) 44 ... Diaphragm 46 ... Gas injection adjusting unit 48 ... Suction pipe 50 ... Suction pump 52 ... Collection container 54 ... Third connection tube 56 ... Suction flow path 58 ... Suction opening 60 ... Suction control unit.

Claims (4)

A fluid ejecting apparatus for performing excision of the excision site by ejecting fluid from the fluid ejection opening toward the excision site,
A fluid chamber capable of supplying fluid;
An inlet channel and an outlet channel communicating with the fluid chamber;
A pulsation generator for applying a pulsating flow to the fluid in the fluid chamber based on a drive signal;
A fluid ejection pipe for ejecting a fluid from a fluid ejection opening communicating with the outlet flow path;
Forming a gas injection channel between the outer peripheral surface of the fluid injection tube, and a gas injection tube for injecting gas from a gas injection opening communicating with the end of the gas injection channel;
The fluid ejection opening is a gas ejection adjustment unit for adjusting the ejection direction of the gas ejected from the gas ejection opening, and the opening angle of the conical side surface of the outer wall of the fluid ejection opening can be adjusted. Equipped with a gas injection adjustment unit ,
The fluid ejecting apparatus according to claim 1, wherein an outer diameter of the fluid ejecting pipe at the fluid ejecting opening is larger than an outer diameter of the fluid ejecting pipe at a position closer to the fluid chamber than the fluid ejecting opening. The fluid ejection device according to claim 1,
The fluid ejecting apparatus , wherein the opening angle decreases as the amount of gas flowing through the gas ejection flow path increases . The fluid ejection device according to claim 1 or 2,
Forming a suction channel between the outer peripheral surface of the gas injection pipe,
A fluid ejecting apparatus, further comprising a suction pipe for providing a suction opening communicating with an end of the suction flow path.   A medical device comprising the fluid ejection device according to claim 1.

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